Slip Disc / Herniated Disc

Our Approach to Managing Slipped Disc / Herniated Disc

Precision. Relief. Restored Mobility.

At Shree Hospitals, we combine patient-centred spine care with the latest diagnostic and surgical expertise to manage slip disc and herniated disc conditions in Mumbai.

Our multidisciplinary spine team evaluates every patient comprehensively mapping the exact level of disc herniation, assessing the degree of nerve compression, and designing a personalised treatment pathway that prioritises non-surgical recovery while reserving surgery for cases that truly need it.

When a patient presents with symptoms of a herniated disc, our spine specialists conduct an immediate neurological evaluation alongside advanced MRI imaging to determine which disc has herniated, the direction of disc material extrusion, and whether the spinal cord or nerve roots are compromised.

This precise assessment is essential because the location and severity of herniation directly dictate the most appropriate course of back pain treatment.

• High-resolution MRI for disc level identification and herniation characterisation
• CT myelography for patients where MRI is contraindicated
• Neurological examination power, reflexes, and sensory testing across all affected dermatomes
• Electromyography (EMG) and nerve conduction studies for chronic or atypical presentations
• Functional assessment of spinal mobility, posture, and gait

Research consistently shows that the majority of herniated disc cases resolve with conservative management when diagnosis is accurate and treatment is started early (Spine Journal, 2023).

Our approach reflects this by exhausting non-surgical options first and proceeding to minimally invasive or open surgery only when clinically necessary.

• Personalised care plans based on disc level, herniation type, and patient activity demands
• Minimally invasive procedures to reduce recovery time and surgical risk
• Coordinated physiotherapy and spine rehabilitation from day one
• Regular follow-up imaging to track disc recovery and nerve healing

Our spine care team operates seven days a week ensuring that patients in acute nerve compression crises receive emergency attention without delay.

1. Advanced Spinal Diagnostic Imaging & Neurological Assessment

Accurate diagnosis is the most critical step in managing a herniated disc. Not all back pain is disc-related, and not all disc herniations require the same treatment — precise imaging and neurological mapping determine the best path forward.

• 1.5T MRI spine (cervical, thoracic, or lumbar) for soft tissue, disc, and nerve visualisation
• CT scan with sagittal and coronal reformats for bony canal assessment
• Discography to identify symptomatic disc levels in multi-level degeneration
• EMG & nerve conduction velocity (NCV) studies to quantify nerve damage
• Dermatomal sensory mapping to identify specific nerve root involvement
• Postural analysis and spinal alignment assessment using digital radiography

This multi-modal diagnostic approach eliminates guesswork and ensures that every treatment decision is backed by objective clinical evidence.

2. Non-Surgical & Conservative Management

The majority of slip disc patients, particularly those without progressive neurological deficits, achieve significant and lasting relief through structured non-surgical treatment. Our spine specialists are committed to maximising conservative outcomes before considering intervention.

• Physiotherapy & Targeted Exercise — Specific core stabilisation and McKenzie method exercises to relieve nerve pressure, strengthen supporting muscles, and improve spinal mechanics.
• Traction Therapy—Mechanical or manual traction to gently distract the disc space, reducing herniation size and nerve root pressure.
• Oral Medication Management — Anti-inflammatories (NSAIDs), muscle relaxants, and neuropathic pain agents (gabapentin, pregabalin) to manage acute symptoms.
• TENS & Ultrasound Therapy — Electrophysical modalities to reduce pain and muscle spasm during the acute phase.
• Hot & Cold Therapy Protocols — Targeted application to control inflammation and promote muscle relaxation.
• Postural Re-education & Ergonomic Advice — Correcting spinal loading patterns at work and home to prevent recurrence.

Conservative management is monitored closely with clinical reassessment at 4–6 week intervals. If symptoms persist or worsen, intervention options are escalated.

3. Minimally Invasive Spine Procedures

For patients who do not respond adequately to conservative treatment, minimally invasive procedures offer targeted pain relief and nerve decompression without the risks and recovery of open surgery.

• Epidural Steroid Injections (ESI) — Anti-inflammatory corticosteroid delivered precisely to the affected nerve root under fluoroscopic or CT guidance to reduce radicular pain and nerve swelling rapidly.
• Transforaminal Nerve Root Block — Targeted injection at the specific exiting nerve root, serving both diagnostic and therapeutic purposes.
• Radiofrequency Ablation (RFA) — Thermal energy is used to ablate pain-transmitting nerve fibres in chronic facet-related disc disease, providing long-lasting relief without surgery.
• Nucleoplasty / Percutaneous Disc Decompression — A probe is inserted into the disc under imaging guidance to remove or ablate a portion of the disc nucleus, reducing internal disc pressure and herniation size.
• Intradiscal Electrothermal Therapy (IDET) — Thermal treatment of the disc wall for chronic discogenic pain without frank herniation.

These procedures may be performed as day-care interventions, depending on the patient's condition and the procedure involved. The need for hospital admission and the time required to resume light activities vary from person to person.

4. Advanced Spine Surgery

Surgery is recommended when non-surgical treatments fail to provide adequate relief or when progressive neurological deficit — worsening weakness, numbness, or loss of bladder/bowel control — demands urgent decompression. Our spine surgeons are trained in the full spectrum of modern disc surgery techniques.

• Microdiscectomy — The gold standard for lumbar disc herniation. Using a high-powered microscope, the herniated disc fragment is removed through a 2–3 cm incision, providing immediate nerve decompression with minimal muscle disruption. Most patients are mobilised on the day of surgery.
• Endoscopic Discectomy — Ultra-minimally invasive removal of the herniated disc through a 7 mm endoscopic portal. General anaesthesia is not required in many cases, offering one of the fastest recovery profiles.
• Anterior Cervical Discectomy & Fusion (ACDF) — For cervical (neck) disc herniation, the damaged disc is removed through the front of the neck and the affected vertebral level is fused with a cage and plate to relieve arm pain, weakness, and spinal cord compression.
• Cervical Disc Replacement (Arthroplasty) — An artificial disc prosthesis replaces the damaged disc while preserving natural neck movement, making it a preferred alternative to fusion in suitable patients.
• Lumbar Spinal Fusion (TLIF / PLIF) — Recommended for disc herniation associated with spinal instability or spondylolisthesis. The affected level is stabilised using screws, rods, and an interbody cage following disc removal.
• Artificial Disc Replacement (ADR) — A motion-preserving lumbar disc arthroplasty for carefully selected patients, helping avoid the long-term adjacent-level stress associated with spinal fusion.

All spine surgeries at Shree Hospitals are performed using intraoperative neuromonitoring (IONM) to ensure spinal cord and nerve root integrity throughout the procedure.

5. Spinal Rehabilitation & Long-Term Recovery

Surgical or non-surgical treatment for a herniated disc is only the beginning — a dedicated rehabilitation programme is what transforms pain relief into lasting, functional recovery.

• Physiotherapy beginning the day after surgery or within the first week of conservative treatment
• Gradual return-to-movement protocol — sitting, standing, and walking progressively advanced
• Core stabilisation programme targeting deep spinal muscles (multifidus, transversus abdominis)
• Hydrotherapy for patients with acute pain or post-surgical sensitivity
• Functional capacity evaluation before return to work or sport
• Ergonomic workplace and lifestyle modifications to prevent recurrence
• MRI follow-up at 3 and 12 months to confirm disc resorption or surgical outcome
• Pain management review and medication tapering under specialist supervision

Our goal is not just decompression — it is complete, durable recovery that allows patients to return to the life they had before disc pain.